<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Recharge_amount')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-recharge_amount" data-rule="required" class="form-control" step="0.01" name="row[recharge_amount]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bonus_amount')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bonus_amount" data-rule="required" class="form-control" step="0.01" name="row[bonus_amount]" type="number">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
        </div>
    </div>
</form>
